jumping through hoops for a new DME

it's never as easy as I think it should be

I am in the process of looking for a new DME (my old one got nabbed for some kind of medicare fraud and my insurance co. did not know - they appreciated my phone call when I asked about other area providers after I read about it in the morning paper a few weeks ago <g>)

So I go out this morning to the mom and pop nearby with a list of what I needed for supplies including Resmed part numbers to make their life easier. "Here's my prescription in case you need it and my ins. card - I need tubing, mask, pillows, filters, humidifier chamber, etc." They say I need a newer script dated within the past 12 months (what? I thought they were good forever?) and a copy of my sleep study --- huh? (( I'm thinking to myself- All I want are supplies, I do not need a machine or want you touching the machines that I do have already.)) So come to find out after a call to BC/BS the new DME that I choose will need script dated within a year and a copy of my sleep study so they can bill BC/BS. Oh...Kaaaay

If my out of network deductible wasn't so high ($1000) to cpap.com , I would do it in a heartbeat but since I have already met my mere $400 medical deductible for the year and they will pay 90% I guess I will get a new dated script copy from the doc and bring them a copy of my copy of the study from 2010 along with the long list of what I want (gonna stock up for 2012 before the of the year since I have no limits on what I can get (well except for a NEW MACHINE;-) I love my insurance plan - Heck, maybe I could sneak one by BC/BS at this point.

this stuff is just so much more complicated than it needs to be

My DME supplier requires a new script every 12 months - I don't have an issue with this, but if you can obtain a 99-yr script you should be good for a while

Fortunately, my DME deals ONLY with XPAP supplies/service and they obtain the new scripts for most patients as they have a working relationship with many of the doctors in our area relating to sleep issues.

The DMEs are bound by the law regarding scripts, so yours isn't unusual.

Cheers,
xena

Seems to be the standard. My doc wrote mine for 1 year, so I have to go see him again.

I think some state laws require a new script every year but most do not.

Heads up: I have Bluecrap, too.
In 2011, my out of network purchases applied toward my in-network deductible.
I'm hoping for the same for 2012, and will call them to make sure.
Then I'll get way more bang for my buck for the 1st $400 for each of us.
Out-of network is $800 each.
Idiots could save themselves a pile of money--Certainly indicates some funny stuff going on, for sure..
They let the old DME do fraudulent billing--even when I offered PROOF.